Addiction Treatment Facilities’ Medical Director Convicted in $112 Million Addiction Treatment Fraud Scheme
The United States Department of Justice, March 24, 2022
The Medical Director of two South Florida addiction treatment facilities was convicted today after a 15-day trial of engaging in a scheme that fraudulently billed approximately $112 million for substance abuse services that were never provided or were medically unnecessary.
“Santeiro’s conviction demonstrates the unwavering commitment of the Department of Justice’s Sober Homes Initiative to protecting patients and prosecuting fraudulent substance abuse treatment facilities,” said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. “Rather than ‘do no harm,’ Santeiro, driven by greed, used his medical license to do unconscionable harm to vulnerable patients struggling with addiction. The department will relentlessly pursue these cases to ensure patients get the care they deserve.”
According to court documents and evidence presented at trial, Jose Santeiro, 72, of Miami Lakes, Florida, a doctor, worked with others to unlawfully bill for approximately $112 million of addiction treatment services that were never rendered and/or were medically unnecessary at two addiction treatment facilities where Santeiro was the Medical Director. The facilities were Second Chance Detox LLC, dba Compass Detox (Compass Detox), an inpatient detox and residential facility, and WAR Network LLC (WAR), a related outpatient treatment program.
The evidence showed that Santeiro and others admitted patients for medically unnecessary detox services, the most expensive kind of treatment the facilities offered. Patient recruiters offered kickbacks to induce patients to attend the programs and then gave them illegal drugs to ensure admittance for detox at Compass Detox. Evidence at trial also showed that Santeiro submitted false and fraudulent claims for excessive, medically unnecessary urinalysis drug tests that were never used in treatment. Santeiro and others then authorized the readmission of a core group of patients who were shuffled between Compass Detox and WAR to fraudulently bill for as much as possible, even though the patients did not need the expensive treatment for which they were repeatedly admitted. Santeiro also prescribed Compass Detox patients with a so-called “Comfort Drink” to sedate them, ensure they stayed at the facility, and keep them coming back. The evidence further showed that Santeiro’s log-in was used, with his knowledge, by others to sign electronic medical files to make it appear as if Santeiro had provided treatment himself when he did not.
“Fraudulent billing schemes like this deprive vulnerable patients of needed medical care and divert valuable resources from America’s health care system,” said FBI Assistant Director Luis Quesada of the Criminal Investigative Division. “Today’s conviction is a clear warning to anyone engaged in health care fraud that the FBI, together with our partners, will aggressively pursue you and hold you accountable for your actions.”
Santeiro was convicted of conspiracy to commit health care fraud and wire fraud and eight counts of health care fraud. He faces up to 20 years in prison for the conspiracy count and up to 10 years in prison for each health care fraud count. A federal district court judge will determine the sentences after considering the U.S. Sentencing Guidelines and other statutory factors.
The FBI, Department of Health and Human Services, Office of Inspector General, and the Broward County Sherriff’s Office investigated the case.
Senior Litigation Counsel Jim Hayes of the National Rapid Response Strike Force and Trial Attorneys Jamie de Boer and Andrea Savdie of the Criminal Division’s Fraud Section are prosecuting the case.
News article: https://www.justice.gov/opa/pr/addiction-treatment-facilities-medical-director-convicted-112-million-addiction-treatment